NUR 210 Exams 1, 2 & 3 Prep / Nur
210 Principles of Pharmacology Exam
1-3 Latest Practice Test Questions and
Correct Answers Graded A+ Galen
EXAM 1: FOUNDATIONAL PHARMACOLOGY PRINCIPLES
(Questions 1-35)
1. The nurse is preparing to administer a drug that is known to be a weak base
(alkaline). In which part of the GI tract will it be best absorbed?
A) Stomach (acidic environment)
B) Small intestine (slightly alkaline environment)
C) Large intestine
D) Mouth (buccal mucosa)
Rationale: Weak bases are better absorbed in the small intestine where the pH is more
alkaline; weak acids are better absorbed in the acidic stomach . This is determined by
the drug's pKa and the environmental pH.
2. A patient asks the nurse, "What is the difference between drug tolerance and
drug dependence?" The best answer is:
A) "Tolerance means you need more drug to get the same effect; dependence
means your body adapts and you have withdrawal if you stop."
B) "Tolerance and dependence are the same thing."
C) "Tolerance causes addiction; dependence does not."
D) "Dependence is psychological, tolerance is physical."
Rationale: Tolerance is a decreased response requiring higher doses. Dependence is a
physiologic adaptation that results in withdrawal upon abrupt discontinuation. They are
related but distinct concepts .
3. The nurse is reviewing a patient's medication history and notes that the patient
takes St. John's wort. The nurse should be concerned about potential interactions
with which of the following? (Select all that apply)
,A) Oral contraceptives
B) Warfarin
C) Digoxin
D) Acetaminophen
Rationale: St. John's wort induces CYP450 enzymes, reducing the effectiveness of oral
contraceptives, warfarin, digoxin, antiretrovirals, and many other drugs . Patients should
be counseled about these interactions.
4. A patient with a history of anaphylaxis to penicillin receives a new prescription
for a cephalosporin. The nurse should:
A) Administer the cephalosporin without worry because cross-reactivity is rare.
B) Consult with the provider; cross-reactivity may occur, but it is low (1–2%).
C) Give a test dose of the cephalosporin.
D) Refuse to administer the drug.
Rationale: While cross-reactivity between penicillins and cephalosporins is low
(approximately 1–2%), a history of anaphylaxis to penicillin warrants caution. The
provider should be consulted; alternative antibiotics may be chosen .
5. The nurse is administering a drug that is an enzyme inhibitor. Which outcome
would the nurse expect?
A) Faster metabolism of other drugs
B) Increased levels of other drugs metabolized by the same enzyme
C) Decreased effectiveness of the inhibitor drug itself
D) Reduced absorption from the GI tract
Rationale: Enzyme inhibitors slow the metabolism of other drugs that use the same
enzyme pathway, leading to increased serum levels and potential toxicity. This is
clinically significant for drugs with narrow therapeutic indices .
6. A patient is receiving a drug that is subject to enterohepatic recycling. The nurse
understands that this process:
A) Decreases the drug's half-life.
B) Prolongs the drug's duration of action.
C) Causes rapid elimination of the drug.
D) Only occurs with IV drugs.
Rationale: Enterohepatic recycling occurs when a drug is excreted in bile and then
reabsorbed from the intestine, prolonging its presence in the body and extending its
duration of action .
7. The nurse is caring for a patient with severe burns. Which pharmacokinetic
process is most likely altered?
A) Metabolism due to liver damage
, B) Excretion due to kidney failure
C) Distribution due to loss of plasma proteins and fluid shifts
D) Absorption due to GI mucosal damage
Rationale: Burns cause loss of plasma proteins (including albumin) and fluid shifts,
altering drug distribution (e.g., increased free drug fraction). Absorption and metabolism
may also be affected, but distribution is primary .
8. The nurse is administering an intravenous infusion of a drug. The nurse notes
that the infusion site is swollen, cool, and pale. The IV has infiltrated. The nurse
should:
A) Continue the infusion; these are normal findings.
B) Discontinue the IV and restart in another site.
C) Apply heat to the infusion site.
D) Slow the infusion rate.
Rationale: Signs of IV infiltration include swelling, coolness, and pallor at the infusion
site. The IV should be discontinued immediately and restarted in another site to prevent
tissue damage .
9. The therapeutic index of a drug refers to:
A) Its chemical structure
B) The margin between effective and toxic dose
C) Its absorption rate
D) Its shelf life
Rationale: A narrow therapeutic index means close monitoring is required. The
therapeutic index is the ratio between the toxic and therapeutic concentrations of a
drug .
10. When should peak drug levels be drawn?
A) Immediately before giving the next dose
B) When the drug concentration is highest in the bloodstream
C) 24 hours after administration
D) Before the first dose
Rationale: Peak levels confirm that dosing achieves effective therapeutic concentration.
For IV medications, the peak is typically drawn 30-60 minutes after infusion completion .
11. The nurse explains to a patient that a side effect is:
A) A harmful, unintended reaction only
B) An expected secondary effect of a drug
C) A toxic reaction
D) A placebo effect
210 Principles of Pharmacology Exam
1-3 Latest Practice Test Questions and
Correct Answers Graded A+ Galen
EXAM 1: FOUNDATIONAL PHARMACOLOGY PRINCIPLES
(Questions 1-35)
1. The nurse is preparing to administer a drug that is known to be a weak base
(alkaline). In which part of the GI tract will it be best absorbed?
A) Stomach (acidic environment)
B) Small intestine (slightly alkaline environment)
C) Large intestine
D) Mouth (buccal mucosa)
Rationale: Weak bases are better absorbed in the small intestine where the pH is more
alkaline; weak acids are better absorbed in the acidic stomach . This is determined by
the drug's pKa and the environmental pH.
2. A patient asks the nurse, "What is the difference between drug tolerance and
drug dependence?" The best answer is:
A) "Tolerance means you need more drug to get the same effect; dependence
means your body adapts and you have withdrawal if you stop."
B) "Tolerance and dependence are the same thing."
C) "Tolerance causes addiction; dependence does not."
D) "Dependence is psychological, tolerance is physical."
Rationale: Tolerance is a decreased response requiring higher doses. Dependence is a
physiologic adaptation that results in withdrawal upon abrupt discontinuation. They are
related but distinct concepts .
3. The nurse is reviewing a patient's medication history and notes that the patient
takes St. John's wort. The nurse should be concerned about potential interactions
with which of the following? (Select all that apply)
,A) Oral contraceptives
B) Warfarin
C) Digoxin
D) Acetaminophen
Rationale: St. John's wort induces CYP450 enzymes, reducing the effectiveness of oral
contraceptives, warfarin, digoxin, antiretrovirals, and many other drugs . Patients should
be counseled about these interactions.
4. A patient with a history of anaphylaxis to penicillin receives a new prescription
for a cephalosporin. The nurse should:
A) Administer the cephalosporin without worry because cross-reactivity is rare.
B) Consult with the provider; cross-reactivity may occur, but it is low (1–2%).
C) Give a test dose of the cephalosporin.
D) Refuse to administer the drug.
Rationale: While cross-reactivity between penicillins and cephalosporins is low
(approximately 1–2%), a history of anaphylaxis to penicillin warrants caution. The
provider should be consulted; alternative antibiotics may be chosen .
5. The nurse is administering a drug that is an enzyme inhibitor. Which outcome
would the nurse expect?
A) Faster metabolism of other drugs
B) Increased levels of other drugs metabolized by the same enzyme
C) Decreased effectiveness of the inhibitor drug itself
D) Reduced absorption from the GI tract
Rationale: Enzyme inhibitors slow the metabolism of other drugs that use the same
enzyme pathway, leading to increased serum levels and potential toxicity. This is
clinically significant for drugs with narrow therapeutic indices .
6. A patient is receiving a drug that is subject to enterohepatic recycling. The nurse
understands that this process:
A) Decreases the drug's half-life.
B) Prolongs the drug's duration of action.
C) Causes rapid elimination of the drug.
D) Only occurs with IV drugs.
Rationale: Enterohepatic recycling occurs when a drug is excreted in bile and then
reabsorbed from the intestine, prolonging its presence in the body and extending its
duration of action .
7. The nurse is caring for a patient with severe burns. Which pharmacokinetic
process is most likely altered?
A) Metabolism due to liver damage
, B) Excretion due to kidney failure
C) Distribution due to loss of plasma proteins and fluid shifts
D) Absorption due to GI mucosal damage
Rationale: Burns cause loss of plasma proteins (including albumin) and fluid shifts,
altering drug distribution (e.g., increased free drug fraction). Absorption and metabolism
may also be affected, but distribution is primary .
8. The nurse is administering an intravenous infusion of a drug. The nurse notes
that the infusion site is swollen, cool, and pale. The IV has infiltrated. The nurse
should:
A) Continue the infusion; these are normal findings.
B) Discontinue the IV and restart in another site.
C) Apply heat to the infusion site.
D) Slow the infusion rate.
Rationale: Signs of IV infiltration include swelling, coolness, and pallor at the infusion
site. The IV should be discontinued immediately and restarted in another site to prevent
tissue damage .
9. The therapeutic index of a drug refers to:
A) Its chemical structure
B) The margin between effective and toxic dose
C) Its absorption rate
D) Its shelf life
Rationale: A narrow therapeutic index means close monitoring is required. The
therapeutic index is the ratio between the toxic and therapeutic concentrations of a
drug .
10. When should peak drug levels be drawn?
A) Immediately before giving the next dose
B) When the drug concentration is highest in the bloodstream
C) 24 hours after administration
D) Before the first dose
Rationale: Peak levels confirm that dosing achieves effective therapeutic concentration.
For IV medications, the peak is typically drawn 30-60 minutes after infusion completion .
11. The nurse explains to a patient that a side effect is:
A) A harmful, unintended reaction only
B) An expected secondary effect of a drug
C) A toxic reaction
D) A placebo effect
